• Ir J Med Sci · Feb 2017

    Targeted temperature management in cardiovascular disease complicated by cardiac arrest.

    • M Gorecka, A Hanley, F Burke, P Nolan, and J Crowley.
    • Cardiology Department, University College Hospital Galway, Galway, Ireland. miragorecka791@gmail.com.
    • Ir J Med Sci. 2017 Feb 1; 186 (1): 123-127.

    PurposeThe majority of cardiac arrests occur due to cardiovascular etiology. Targeted temperature management (TTM) (32-34 °C) is a part of the standard post arrest care. We hypothesized that lower body temperature may lead to reduced cardiac metabolic demand and potentially have a beneficial effect on myocardial function.MethodsWe performed a retrospective study on patients admitted to the intensive care unit following cardiac arrest secondary to cardiovascular etiology over a 9 year period. We assessed the impact of TTM on neurological and cardiac outcomes.ResultsThere were 57 patients in the cohort; 21 patients in the TTM group and 36 in the non-TTM group. Demographic characteristics were similar in both groups-the majority of patients (86 vs 80 %, respectively) were males in their 60s. Neurological outcomes were similar; 24 % of patients died during the ICU admission in the TTM group vs 18 % in the non-TTM group. Mean GCS on admission to the ICU was 4 vs 7, respectively, and 11 at discharge in both groups. Majority of patients recovered good neurological function (GCS ≥ 13)-57 % in the TTM group vs 64 % in the non-TTM group. The change in left ventricular function over a 6 month follow up period was significantly better in patients who received targeted temperature management-mean change of +4.4 vs -3.3 %, respectively. This proved to be statistically significant (p = 0.02).ConclusionsThe study demonstrates a possible beneficial effect of TTM on long-term cardiac function, when instituted following cardiac arrest.

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